In part two of "Normal pressure hydrocephalus: the "grown-up" version of an under-recognized problem" we looked at what causes normal pressure hydrocephalus or NPH and how it is diagnosed. In part three we will explore what treatment options are available.
V. What treatment options are available?
The shunt valve is a critical component of the system and the design that has been in use is the differential pressure (DP) valve. It operates by the valve opening when the (fluid) pressure at the inlet of the valve exceeds the (fluid) pressure at the outlet by a preset amount. In adults with hydrocephalus, the valve is sometimes overwhelmed by the effects of gravity, leading to the drainage of too much CSF. The common name for this over-draining is siphoning. In some cases the patient is asymptomatic while others experience headache or nausea while in an upright position. In extreme cases it can also result in so much CSF being drained that it causes subdural hematoma. To counteract this problem, valve mechanisms have been designed that incorporate both anti-siphoning and gravity-compensating mechanisms. The anti-siphoning mechanism component is triggered by a change in the CSF pressure while the gravity-compensating mechanism is triggered by postural changes.
For additional information:
NPH booklet
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